NPI | 1881162162 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WA LW61024306) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG60156882) |
Enumeration Date | 2018-11-05 |
Last Update Date | 2022-11-21 |