NPI | 1801266887 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: IN 33006683A) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY 172413) |
1041C0700X Social Worker Clinical (Licence: IN 99066837A) | |
1041C0700X Social Worker Clinical (Licence: OH I.1600282.SUPV) | |
Enumeration Date | 2015-10-02 |
Last Update Date | 2023-04-17 |