| NPI | 1235622895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: WA SC61239870) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA SC61239870) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2022-02-18 |