NPI | 1063871291 |
---|---|
Professional Name | PHILLIP TARDANICO |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW69611) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A01210315) |
Enumeration Date | 2016-02-16 |
Last Update Date | 2024-06-04 |