NPI | 1306928080 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 286356-3501) |
Enumeration Date | 2006-10-20 |
Last Update Date | 2023-08-22 |