NPI | 1275904658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 99175) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW73410) |
1041C0700X Social Worker, Clinical (Licence: CA 390200000X) | |
104100000X Social Worker (Licence: CA 101Y00000X) | |
Enumeration Date | 2015-10-12 |
Last Update Date | 2021-12-27 |