| NPI | 1346641149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 87260) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW 70100) |
| 1041C0700X Social Worker, Clinical | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2019-01-10 |