NPI | 1669161014 |
---|---|
Other Name | SAM ALLEN TUCKWIN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: OR A14705) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-24-3972) |
101YM0800X Counselor, Mental Health (Licence: OR 23-QMHP-R-2293) | |
104100000X Social Worker (Licence: WA SC61570839) | |
Enumeration Date | 2023-05-02 |
Last Update Date | 2025-03-28 |