NPI | 1265914428 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 9510-123) |
Additional Taxonomies | 104100000X Social Worker (Licence: WI 131117) |
1041C0700X Social Worker, Clinical | |
Enumeration Date | 2018-09-04 |
Last Update Date | 2021-08-06 |