NPI | 1568189918 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: LA PLC9877) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
101YM0800X Counselor, Mental Health (Licence: LA 1568189918) | |
Enumeration Date | 2022-10-26 |
Last Update Date | 2023-12-14 |