| NPI | 1720229172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional (Licence: FL IMH 13452) | |
| 101YP1600X Counselor, Pastoral | |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2016-01-05 |