NPI | 1184246597 |
---|---|
Other Name | LAWRENCE A DEFIESTA |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 10499-M) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P014490) |
Enumeration Date | 2020-05-08 |
Last Update Date | 2024-04-18 |