| NPI | 1467885327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: LA 6958) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 6958) |
| 171M00000X Case Manager/Care Coordinator (Licence: LA 6958) | |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2022-11-30 |