NPI | 1255897518 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05974800) |
Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL06262500) |
104100000X Social Worker (Licence: PA SW133566) | |
Enumeration Date | 2019-02-12 |
Last Update Date | 2021-02-01 |