NPI | 1023757580 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 118654) |
Additional Taxonomies | 172V00000X Community Health Worker (Licence: CA 118654) |
171M00000X Case Manager/Care Coordinator (Licence: CA 118654) | |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2022-06-02 |
Last Update Date | 2024-10-01 |