NPI | 1295059517 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 75566) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
1041C0700X Social Worker, Clinical (Licence: CA ASW27486) | |
Enumeration Date | 2010-03-15 |
Last Update Date | 2020-02-20 |