NPI | 1639687866 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106S00000X Behavior Technician |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 173258) |
171M00000X Case Manager/Care Coordinator | |
175T00000X Peer Specialist | |
Enumeration Date | 2018-01-22 |
Last Update Date | 2024-06-04 |