NPI | 1326563065 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA LCSW83047) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA 34229) |
1041C0700X Social Worker Clinical (Licence: CA ASW34229) | |
Enumeration Date | 2017-08-03 |
Last Update Date | 2018-06-29 |