Individual
MR. DAVID CHARLES MACK
Active
Individual
MR. DAVID CHARLES MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW(MA), LCSW(AZ)
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
111748
MA
1041C0700X
Clinical Social Worker
Primary
LCSW-14109
AZ
Other
Enumeration date
11/28/2006
Last updated
04/13/2015
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