| NPI | 1548744097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW61268579) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: LA 14655) |
| 104100000X Social Worker (Licence: LA 14655) | |
| Enumeration Date | 2018-09-20 |
| Last Update Date | 2025-04-02 |