NPI | 1265815062 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 62896) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 62896) |
101Y00000X Counselor (Licence: CT 001831) | |
104100000X Social Worker (Licence: CT 001831) | |
104100000X Social Worker (Licence: TX 62896) | |
Enumeration Date | 2015-06-30 |
Last Update Date | 2023-07-28 |