NPI | 1396340881 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW121389) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 97481) |
104100000X Social Worker (Licence: CA ACSW97481) | |
1041C0700X Social Worker, Clinical (Licence: CA ACSW97481) | |
Enumeration Date | 2020-12-02 |
Last Update Date | 2024-03-13 |