NPI | 1437669272 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 4614) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 180010948) |
1041C0700X Social Worker, Clinical | |
Enumeration Date | 2017-10-06 |
Last Update Date | 2018-01-18 |