| NPI | 1235539495 |
|---|---|
| Former Name | CHARLES WASHINGTON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 372600000X Adult Companion | |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2022-08-29 |