| NPI | 1861348096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 247200000X Technician, Other |
| 174400000X Specialist | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2026-03-09 |
| Last Update Date | 2026-03-19 |