| NPI | 1942808357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 10314-C) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT Ic-1631) |
| 104100000X Social Worker (Licence: NV 8842-S) | |
| 1041C0700X Social Worker, Clinical (Licence: NV IC-1631) | |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2024-02-05 |