NPI | 1609818715 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149008194) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-19024) |
Enumeration Date | 2006-06-12 |
Last Update Date | 2023-07-07 |