| NPI | 1437714821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 106741) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 89873) |
| 104100000X Social Worker (Licence: CA 89873) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2022-02-25 |