| NPI | 1144773904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 108574) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 101YM0800X Counselor, Mental Health (Licence: CA 77866) | |
| 104100000X Social Worker (Licence: CA 77866) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2024-12-09 |