| NPI | 1649658790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05776500) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW020076) |
| 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-20537) | |
| 1041C0700X Social Worker, Clinical (Licence: FL SW20552) | |
| 1041S0200X Social Worker, School (Licence: NJ 00419755) | |
| Enumeration Date | 2015-05-09 |
| Last Update Date | 2022-11-22 |