NPI | 1518331289 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801084225) |
Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801084225) |
1041S0200X Social Worker, School (Licence: MI 6801084225) | |
Enumeration Date | 2015-11-18 |
Last Update Date | 2015-11-18 |