NPI | 1487665923 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 14424) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 14424) |
Enumeration Date | 2006-08-10 |
Last Update Date | 2024-10-16 |