| NPI | 1043423494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW 00009576) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OK 2795) |
| 1041C0700X Social Worker, Clinical (Licence: AR 1797-C) | |
| 1041C0700X Social Worker, Clinical (Licence: MO 2004011463) | |
| 1041C0700X Social Worker, Clinical (Licence: FL SW 6186) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2011-12-02 |