| NPI | 1437511367 |
|---|---|
| Former Name | RAYMOND EDWIN MANGELSDORF |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW007931) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C011021) |
| Enumeration Date | 2016-03-21 |
| Last Update Date | 2023-06-07 |