NPI | 1306160874 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 83143) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ACSW 36186) |
104100000X Social Worker (Licence: CA ACSW 36186) | |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2010-03-26 |
Last Update Date | 2021-01-13 |