| NPI | 1720441918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 225C00000X Rehabilitation Counselor | |
| 372600000X Adult Companion | |
| 3747P1801X Technician Personal Care Attendant | |
| 376J00000X Homemaker | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2016-04-04 |