| NPI | 1568058030 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: OH CHW.002386) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2102995-TRNE) |
| 171M00000X Case Manager/Care Coordinator | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2024-10-21 |