NPI | 1760280341 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LMSW-17689) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ 17689) |
Enumeration Date | 2025-03-07 |
Last Update Date | 2025-03-07 |