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 |