NPI | 1407046535 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: NV 4913S) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 01168-L) |
1041C0700X Social Worker, Clinical (Licence: NV IC-504) | |
Enumeration Date | 2007-07-25 |
Last Update Date | 2023-08-29 |