| NPI | 1619859543 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACA.0008414) |
| Enumeration Date | 2025-07-22 |
| Last Update Date | 2025-07-23 |