NPI | 1568890721 |
---|---|
Former Name | CHAZ HOLMON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC500080588) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 19256) |
Enumeration Date | 2013-10-28 |
Last Update Date | 2022-06-10 |