| NPI | 1598110645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA asw68759) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW68759) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2019-01-02 |