NPI | 1043789555 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW121016) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
175T00000X Peer Specialist | |
Enumeration Date | 2018-11-14 |
Last Update Date | 2025-09-05 |