| NPI | 1477371144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 273R00000X Psychiatric Unit |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106S00000X Behavior Technician | |
| 167G00000X Licensed Psychiatric Technician | |
| 247200000X Technician, Other | |
| 283Q00000X Psychiatric Hospital | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 374700000X Technician | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-10-01 |