| NPI | 1801248760 |
|---|---|
| Former Name | RAYMOND EDWARD TAEGER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801104488) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801099547) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2024-08-02 |