| NPI | 1528890993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner |
| Additional Taxonomies | 102X00000X Poetry Therapist |
| 156F00000X Technician/Technologist | |
| 174400000X Specialist | |
| 225A00000X Music Therapist | |
| 225CA2500X Rehabilitation Counselor, Assistive Technology Supplier | |
| 101200000X Drama Therapist | |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2024-08-15 |