| NPI | 1437695376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA E1060944) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW111065) |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2024-05-16 |