| NPI | 1124402755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN LSW0000007127) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TN 7127) |
| 101YP2500X Counselor, Professional | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2024-09-05 |