| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
|
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 102X00000X Poetry Therapist |
| 103K00000X Behavior Analyst |
| 1041C0700X Social Worker, Clinical |
| 1041S0200X Social Worker, School |
| 1744R1102X Specialist, Research Study |
| 1744R1103X Specialist, Research Data Abstracter/Coder |
| 174H00000X Health Educator |
| 225800000X Recreation Therapist |
| 226300000X Kinesiotherapist |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2019-01-07 |