NPI | 1831683606 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW021294) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC06100000) |
1041C0700X Social Worker, Clinical (Licence: OH I.2002248) | |
Enumeration Date | 2018-06-15 |
Last Update Date | 2024-01-07 |