NPI | 1629442231 |
---|---|
Former Name | SEAN SMITH |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149019678) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 34978) |
104100000X Social Worker (Licence: DC LG50081367) | |
104100000X Social Worker (Licence: MD 20792) | |
Enumeration Date | 2015-11-19 |
Last Update Date | 2021-04-22 |