NPI | 1285453894 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 128926) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
1041S0200X Social Worker, School | |
Enumeration Date | 2024-10-09 |
Last Update Date | 2025-02-28 |