NPI | 1295020816 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW61472615) |
Additional Taxonomies | 1041S0200X Social Worker, School (Licence: IA LW61472615) |
Enumeration Date | 2011-06-10 |
Last Update Date | 2025-04-07 |