NPI | 1336579150 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 70385) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW 37359) |
1041C0700X Social Worker, Clinical (Licence: TN LCSW 4642) | |
Enumeration Date | 2013-11-14 |
Last Update Date | 2022-04-21 |