| NPI | 1871316943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA SC61545450) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WA SC61545450) |
| 171M00000X Case Manager/Care Coordinator (Licence: WA SC61545450) | |
| Enumeration Date | 2024-11-06 |
| Last Update Date | 2024-11-06 |