NPI | 1982109617 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
Additional Taxonomies | 101Y00000X Counselor |
106S00000X Behavior Technician | |
172V00000X Community Health Worker | |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2018-03-26 |
Last Update Date | 2025-07-14 |