NPI | 1356902886 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C014182) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS-24750) |
104100000X Social Worker (Licence: SC 13077) | |
1041C0700X Social Worker Clinical (Licence: NC P013574) | |
Enumeration Date | 2019-06-25 |
Last Update Date | 2021-11-01 |