| NPI | 1245601772 |
|---|---|
| Former Name | TRAVIS H BROWN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 11401-123) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 132330-121) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16017-132) | |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2023-09-26 |