| NPI | 1952892838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: FL CBHCMS0101215) |
| Additional Taxonomies | 251B00000X Case Management (Licence: FL CBHCMS0101215) |
| 101YM0800X Counselor, Mental Health (Licence: FL IMH27926) | |
| 171M00000X Case Manager/Care Coordinator (Licence: FL CBHCMS.0101215) | |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2026-05-12 |