NPI | 1326294679 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA LCS 29037) |
Additional Taxonomies | 104100000X Social Worker |
101YM0800X Counselor Mental Health | |
Enumeration Date | 2008-08-18 |
Last Update Date | 2018-09-19 |