| NPI | 1013186030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 6384-C) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: UT 5580876-3502) |
| 101YM0800X Counselor, Mental Health (Licence: UT 5580876-3502) | |
| 1041C0700X Social Worker, Clinical (Licence: UT 5580876-3502) | |
| Enumeration Date | 2008-02-23 |
| Last Update Date | 2023-09-04 |