| NPI | 1841602141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 8370C) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR 8370-C) |
| 1041C0700X Social Worker, Clinical (Licence: AR 8370-C) | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2023-12-16 |