NPI | 1578070744 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: CA 87485) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 87458) |
1041C0700X Social Worker, Clinical (Licence: CA 87946) | |
Enumeration Date | 2018-01-09 |
Last Update Date | 2024-02-01 |