| NPI | 1437500691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KS 03246) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 03246) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2021-03-02 |