| NPI | 1740802941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP1600X Counselor, Pastoral | |
| 103K00000X Behavior Analyst | |
| 1041S0200X Social Worker, School | |
| 172V00000X Community Health Worker | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 1041S0200X Social Worker, School | |
| 374700000X Technician | |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2023-04-24 |