NPI | 1679942502 |
---|---|
Former Name | CLINT D FISHER |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: NY 094326) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.1200134) |
Enumeration Date | 2015-09-22 |
Last Update Date | 2024-04-16 |