NPI | 1497411086 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: WA SC60309236) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA CG60294779) |
Enumeration Date | 2021-11-09 |
Last Update Date | 2022-07-20 |