NPI | 1053785287 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 15247) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2015-11-27 |
Last Update Date | 2023-09-21 |