| NPI | 1437611647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC61185977) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG60953571) |
| 171M00000X Case Manager/Care Coordinator (Licence: WA MC61185977) | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2024-05-14 |