| NPI | 1467995241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist (Licence: CA 1467995241) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2026-04-06 |