| NPI | 1255473831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW00009354) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NV 10590-C) |
| 1041C0700X Social Worker, Clinical (Licence: TX 111458) | |
| 1041C0700X Social Worker, Clinical (Licence: UT 13348744-3501) | |
| 1041C0700X Social Worker, Clinical (Licence: OH I.2304933) | |
| 1041C0700X Social Worker, Clinical (Licence: OR L8526) | |
| 1041C0700X Social Worker, Clinical (Licence: MN 32494) | |
| 1041C0700X Social Worker, Clinical (Licence: FL SW21414) | |
| 1041C0700X Social Worker, Clinical (Licence: CO CSW.09929019) | |
| 1041C0700X Social Worker, Clinical (Licence: NM SWB-2023-0376) | |
| 1041C0700X Social Worker, Clinical (Licence: IL 149025864) | |
| 1041C0700X Social Worker, Clinical (Licence: ID LCSW-43728) | |
| 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-21295) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2023-11-20 |