NPI | 1427524636 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW61088963) |
Additional Taxonomies | 104100000X Social Worker (Licence: WA LW61088963) |
Enumeration Date | 2018-10-16 |
Last Update Date | 2021-06-07 |