| NPI | 1174030266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2208295) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6802089656) |
| 1041C0700X Social Worker, Clinical (Licence: OH 000566635) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2022-11-17 |