NPI | 1952052649 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 80773) |
Enumeration Date | 2022-01-13 |
Last Update Date | 2024-02-13 |