| NPI | 1083995781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 082721) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05800500) |
| 1041C0700X Social Worker, Clinical (Licence: PA CW021693) | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2024-03-28 |