| NPI | 1568868545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 900-4-15-17) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: ND 900-4-15-17) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2021-10-21 |