| NPI | 1427591221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW126097) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149022142) |
| 1041C0700X Social Worker, Clinical (Licence: CO CSW.09927865) | |
| 1041C0700X Social Worker, Clinical (Licence: TN 7982) | |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2024-08-09 |