NPI | 1679778153 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC61138315) |
Additional Taxonomies | 101Y00000X Counselor |
101YP2500X Counselor, Professional (Licence: WA RC00049521) | |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2007-06-15 |
Last Update Date | 2025-03-20 |