NPI | 1720453764 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2015-12-02 |
Last Update Date | 2024-05-29 |