NPI | 1124487988 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 121978) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
104100000X Social Worker (Licence: CA 95128) | |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2016-02-22 |
Last Update Date | 2024-04-10 |