| NPI | 1740790856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-23305) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A1807098) |
| 101YP2500X Counselor, Professional (Licence: AR A1807098) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2024-11-04 |