NPI | 1720471253 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2962) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 5796) |
101YM0800X Counselor, Mental Health (Licence: NE 12234) | |
1041C0700X Social Worker, Clinical (Licence: NE 2113) | |
1041C0700X Social Worker, Clinical (Licence: NE 7489) | |
172V00000X Community Health Worker | |
Enumeration Date | 2015-03-09 |
Last Update Date | 2022-02-26 |