| NPI | 1891310652 |
|---|---|
| Former Name | DE SHAUN MADKINS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MA 228106) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical (Licence: MA LICSW128481) | |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2025-11-12 |