| NPI | 1255331013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX S03283) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 03283) |
| 101YM0800X Counselor, Mental Health (Licence: TX 03283) | |
| 101Y00000X Counselor (Licence: TX 03283) | |
| 171M00000X Case Manager/Care Coordinator (Licence: TX 03283) | |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2008-10-21 |