NPI | 1871997379 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 120381) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA 61312959) |
1041C0700X Social Worker, Clinical (Licence: NH 2094) | |
Enumeration Date | 2014-10-14 |
Last Update Date | 2024-11-22 |