NPI | 1598201881 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0015369) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2017-01-11 |
Last Update Date | 2024-07-01 |