| NPI | 1689843161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AK 146154) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA RC00053968) |
| 101YM0800X Counselor Mental Health (Licence: WA CG60137795) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2025-05-08 |