| NPI | 1013102797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA LCSW85999) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YM0800X Counselor, Mental Health (Licence: CA ASW22982) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2022-08-15 |