| NPI | 1023347911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW101659) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: CA 69833) | |
| 1041C0700X Social Worker, Clinical (Licence: CA 69833) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2009-12-23 |
| Last Update Date | 2023-03-30 |