NPI | 1376165035 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 111259) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 21993) |
Enumeration Date | 2020-05-15 |
Last Update Date | 2024-09-17 |