NPI | 1770885618 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 106S00000X Behavior Technician |
171400000X Health & Wellness Coach | |
171M00000X Case Manager/Care Coordinator | |
172V00000X Community Health Worker | |
Enumeration Date | 2010-11-29 |
Last Update Date | 2023-06-06 |