| NPI | 1083956528 | 
|---|---|
| Former Name | TYLER SMITH | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical | 
| Additional Taxonomies | 104100000X Social Worker | 
| 174400000X Specialist (Licence: WA 00217839 CPHQ)  | |
| 174400000X Specialist (Licence: WA PS0141449 CPPS)  | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-22 | 
| Last Update Date | 2021-07-22 |