| NPI | 1528517372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05978700) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 104100000X Social Worker (Licence: NJ 44SL06228200) | |
| 104100000X Social Worker (Licence: NY 098850) | |
| 1041C0700X Social Worker, Clinical (Licence: NY 090668) | |
| 1041C0700X Social Worker, Clinical (Licence: TX 107834) | |
| 1041C0700X Social Worker, Clinical (Licence: FL TPSW1737) | |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2022-07-07 |