| NPI | 1750877155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106S00000X Behavior Technician | |
| 172V00000X Community Health Worker | |
| 174H00000X Health Educator | |
| 251K00000X Public Health or Welfare | |
| 251S00000X | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-07-14 |