NPI | 1073981320 |
---|---|
Former Name | SAMARA ROSE KATTEN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 99750) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 72158) |
Enumeration Date | 2015-09-03 |
Last Update Date | 2024-05-27 |