NPI | 1023662467 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 120323) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 95293) |
1041C0700X Social Worker, Clinical (Licence: CA 95293) | |
Enumeration Date | 2019-07-24 |
Last Update Date | 2024-01-18 |