NPI | 1972002889 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KY I.2304244) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: QMHS) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2018-02-06 |
Last Update Date | 2023-08-28 |