NPI | 1548200462 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801091525) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: UT 3222063501) |
1041C0700X Social Worker, Clinical (Licence: OH I1500231) | |
1041C0700X Social Worker, Clinical (Licence: AL 1999C) | |
1041C0700X Social Worker, Clinical (Licence: MS C6753) | |
Enumeration Date | 2006-06-08 |
Last Update Date | 2021-11-16 |