NPI | 1497222582 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: WA CG60533953) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA CG60533953) |
Enumeration Date | 2018-10-27 |
Last Update Date | 2019-09-26 |