| NPI | 1891477303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI CSW04302) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA LCSW2141549) |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2026-08-20 |