NPI | 1255874467 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL SW12911) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW 12911) |
Enumeration Date | 2016-11-21 |
Last Update Date | 2022-08-11 |