NPI | 1275608192 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: NC C005490) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C005490) |
101YM0800X Counselor, Mental Health (Licence: NC C005490) | |
101YP2500X Counselor, Professional (Licence: NC C005490) | |
Enumeration Date | 2006-11-24 |
Last Update Date | 2024-07-15 |