| NPI | 1386073823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC50078630) |
| Additional Taxonomies | 101200000X Drama Therapist (Licence: NY 739) |
| 1041C0700X Social Worker, Clinical (Licence: MD 14940) | |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904008459) | |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2024-08-01 |