NPI | 1568801587 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC50080419) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DC PRC985) |
Enumeration Date | 2013-06-24 |
Last Update Date | 2023-01-30 |