NPI | 1144086208 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 13689033-3502) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 13689033-3502) |
Enumeration Date | 2024-02-26 |
Last Update Date | 2024-02-26 |