| NPI | 1780987362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AR P2108017) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AR A1708247) |
| 101YM0800X Counselor Mental Health (Licence: AR P2108017) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2010-12-21 |
| Last Update Date | 2021-10-27 |