| NPI | 1992342000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 86170) |
| 171M00000X Case Manager/Care Coordinator | |
| 171M00000X Case Manager/Care Coordinator (Licence: LA PLC8141) | |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2022-01-25 |