| NPI | 1881025278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC50081341) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 22661) |
| 1041C0700X Social Worker, Clinical (Licence: TX 38774) | |
| 1041C0700X Social Worker, Clinical (Licence: LA 10638) | |
| 1041C0700X Social Worker, Clinical (Licence: AZ 13804) | |
| 1041C0700X Social Worker, Clinical (Licence: MS C8103) | |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2022-10-26 |