NPI | 1588261614 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 112933) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 112933) |
171M00000X Case Manager/Care Coordinator | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-10-01 |
Last Update Date | 2023-06-13 |