| NPI | 1982102059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 171M00000X Case Manager/Care Coordinator | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2023-03-03 |