NPI | 1144731761 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-11414) |
Additional Taxonomies | 103K00000X Behavior Analyst |
104100000X Social Worker (Licence: NM M-10237) | |
1041S0200X Social Worker, School (Licence: NM 372693) | |
Enumeration Date | 2017-10-23 |
Last Update Date | 2021-09-09 |