| NPI | 1144622408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 10161-C) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NV 7857-S) |
| 1041C0700X Social Worker, Clinical (Licence: NV IC-1230) | |
| 1041C0700X Social Worker, Clinical (Licence: NV 10160-C) | |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2025-08-22 |