NPI | 1043440829 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: CA 29152) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 29152) |
Enumeration Date | 2009-07-15 |
Last Update Date | 2018-09-25 |