| NPI | 1366937757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 107568) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 84502) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2022-04-11 |