| NPI | 1881970671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 171M00000X Case Manager/Care Coordinator | |
| 372600000X Adult Companion | |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2024-11-03 |