NPI | 1518672120 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LPC-9658) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2023-01-18 |
Last Update Date | 2023-07-19 |