NPI | 1710752068 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH20524) |
Additional Taxonomies | 104100000X Social Worker (Licence: FL MH20524) |
1041C0700X Social Worker, Clinical (Licence: FL MH20524) | |
171M00000X Case Manager/Care Coordinator (Licence: FL MH20524) | |
Enumeration Date | 2023-11-16 |
Last Update Date | 2023-11-16 |