| NPI | 1932916079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 19665) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: CA 19665) |
| 146L00000X Emergency Medical Technician, Paramedic (Licence: CA 19665) | |
| 146M00000X Emergency Medical Technician, Intermediate (Licence: CA 19665) | |
| 146N00000X Emergency Medical Technician, Basic (Licence: CA 19665) | |
| 171M00000X Case Manager/Care Coordinator (Licence: CA 19665) | |
| 225800000X Recreation Therapist (Licence: CA 19665) | |
| 226000000X Recreational Therapist Assistant (Licence: CA 19665) | |
| 374K00000X Religious Nonmedical Practitioner (Licence: CA 19665) | |
| 405300000X Prevention Professional (Licence: CA 19665) | |
| Enumeration Date | 2024-12-12 |
| Last Update Date | 2024-12-12 |