| NPI | 1346698388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 135189) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 171M00000X Case Manager/Care Coordinator | |
| 104100000X Social Worker (Licence: CA 92867) | |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2025-11-18 |