NPI | 1245540822 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 110224) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health | |
106H00000X Marriage & Family Therapist | |
Enumeration Date | 2010-10-15 |
Last Update Date | 2023-02-07 |