| NPI | 1487549713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 171400000X Health & Wellness Coach | |
| 172A00000X Driver | |
| Enumeration Date | 2025-06-09 |
| Last Update Date | 2025-07-24 |