NPI | 1184993602 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY34286) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS 27744) |
225C00000X Rehabilitation Counselor | |
Enumeration Date | 2011-12-29 |
Last Update Date | 2023-07-14 |