NPI | 1134519515 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA ACSW97554) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2015-01-23 |
Last Update Date | 2023-06-08 |