| NPI | 1316320872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA ACSW122792) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 104100000X Social Worker (Licence: CA ACSW122792) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2024-11-12 |