| NPI | 1508350851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225C00000X Rehabilitation Counselor |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103K00000X Behavior Analyst (Licence: CA F5130372) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2025-03-27 |