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 |