NPI | 1184192221 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C012706) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW15534) |
1041S0200X Social Worker, School (Licence: FL SW15534) | |
Enumeration Date | 2018-11-07 |
Last Update Date | 2024-01-26 |