Individual
IVAYLO HRISTOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7835-123
WI
1041C0700X
Clinical Social Worker
ASW 17168
CA
1041C0700X
Clinical Social Worker
LCSW27688
CA
Other
Enumeration date
11/20/2006
Last updated
01/31/2019
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