NPI | 1851015077 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
1041C0700X Social Worker, Clinical | |
106S00000X Behavior Technician | |
Enumeration Date | 2022-09-30 |
Last Update Date | 2023-05-08 |