NPI | 1326390410 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA AP7950) |
Additional Taxonomies | 103T00000X Psychologist |
171M00000X Case Manager/Care Coordinator | |
101YP2500X Counselor, Professional | |
101YM0800X Counselor, Mental Health (Licence: CA AP7950) | |
Enumeration Date | 2012-10-12 |
Last Update Date | 2024-01-23 |