NPI | 1932570942 |
---|---|
Former Name | WILLIE EUGENE ALLEN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: LA PLC9419) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA PLC9419) |
171M00000X Case Manager/Care Coordinator (Licence: LA PLC9419) | |
Enumeration Date | 2015-10-16 |
Last Update Date | 2024-03-27 |