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Individual
MR. IVAN THOMAS SMALLS JR.
Active
Individual
MR. IVAN THOMAS SMALLS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NJ
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/09/2022
Last updated
02/09/2022
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