| NPI | 1821680653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC06226900) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC003100300) |
| 171M00000X Case Manager/Care Coordinator | |
| 104100000X Social Worker (Licence: NJ 44SL06550300) | |
| Enumeration Date | 2021-02-03 |
| Last Update Date | 2024-02-17 |