NPI | 1124885900 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CA 121163) |
Additional Taxonomies | 1041C0700X Social Worker Clinical |
Enumeration Date | 2024-02-28 |
Last Update Date | 2024-02-28 |