NPI | 1336456375 |
---|---|
Former Name | GAMALIEL BELTRAN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 79913) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 31783) |
Enumeration Date | 2010-09-13 |
Last Update Date | 2017-11-20 |