NPI | 1386212017 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 102808) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 102808) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2021-06-17 |
Last Update Date | 2023-06-30 |