| NPI | 1215275771 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 87464) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 6922) |
| 104100000X Social Worker | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2024-04-05 |