NPI | 1659021624 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor Mental Health | |
Enumeration Date | 2022-03-24 |
Last Update Date | 2025-07-29 |