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Individual
MR. MARK ANDREW HEAD
Active
Individual
MR. MARK ANDREW HEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, CASAC
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
RO28217
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RO28217
CLINICAL SOCIAL WORKER
NY
Enumeration date
03/19/2007
Last updated
07/08/2007
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