| NPI | 1669607438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006622) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC006622) |
| 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00832600) | |
| 101YM0800X Counselor, Mental Health (Licence: LA 9305) | |
| 171M00000X Case Manager/Care Coordinator | |
| 225C00000X Rehabilitation Counselor (Licence: 00083753) | |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2024-02-14 |