NPI | 1598034415 |
---|---|
Former Name | WILLIAM RODRIGUEZ |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW12841) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05487100) |
Enumeration Date | 2011-12-21 |
Last Update Date | 2016-06-12 |