NPI | 1770118069 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health | |
171M00000X Case Manager/Care Coordinator | |
172V00000X Community Health Worker | |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2020-03-06 |
Last Update Date | 2025-06-10 |