NPI | 1659517837 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: NC C007062) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC P004680) |
1041C0700X Social Worker, Clinical (Licence: NC P-0004680) | |
1041C0700X Social Worker, Clinical (Licence: NC C 007062) | |
Enumeration Date | 2008-12-18 |
Last Update Date | 2024-07-02 |