NPI | 1154994044 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC P014521) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC P014521) |
Enumeration Date | 2021-07-20 |
Last Update Date | 2022-09-14 |