NPI | 1659989366 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA sw130668) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW021986) |
1041C0700X Social Worker, Clinical (Licence: AK 112509) | |
Enumeration Date | 2020-07-20 |
Last Update Date | 2022-05-19 |