| NPI | 1326473117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 64357) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 104100000X Social Worker (Licence: TX 64357) | |
| 1041S0200X Social Worker School (Licence: TX 64357) | |
| 171M00000X Case Manager/Care Coordinator (Licence: TX 64357) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2023-05-22 |