NPI | 1033312285 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 5970944-3501) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WY lcsw-712) |
1041C0700X Social Worker, Clinical (Licence: NV 8566-C) | |
Enumeration Date | 2007-06-06 |
Last Update Date | 2023-09-26 |