| NPI | 1184478224 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA NA) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA NA) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1557780424) | |
| 1041C0700X Social Worker, Clinical (Licence: CA NA) | |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-08-30 |