NPI | 1487089801 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW91858) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2013-09-04 |
Last Update Date | 2021-03-17 |