NPI | 1184235194 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: CA 102489) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 102489) |
Enumeration Date | 2020-08-13 |
Last Update Date | 2024-08-07 |