| NPI | 1720662554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW007567) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AL 6767C) |
| 1041C0700X Social Worker, Clinical (Licence: TX 116958) | |
| 1041C0700X Social Worker, Clinical (Licence: MN 35421) | |
| 1041C0700X Social Worker, Clinical (Licence: CO CSW.09932654) | |
| 1041C0700X Social Worker, Clinical (Licence: IN 34012124A) | |
| 1041C0700X Social Worker, Clinical (Licence: FL TPSW4156) | |
| Enumeration Date | 2021-05-07 |
| Last Update Date | 2026-08-08 |