| NPI | 1861586018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 111167) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AR 2226-C) |
| 1041C0700X Social Worker, Clinical (Licence: MS C6948) | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical (Licence: TN 4986) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2024-07-09 |