NPI | 1558732792 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW133191) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA ASW113111) |
104100000X Social Worker (Licence: CA ASW113111) | |
Enumeration Date | 2015-10-14 |
Last Update Date | 2025-09-25 |