NPI | 1093383705 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 102416) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: CA 102416) |
Enumeration Date | 2021-06-17 |
Last Update Date | 2024-06-20 |