| NPI | 1649168592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO SWC.0000002510) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CO SWC.0000002510) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2026-06-02 |