| NPI | 1598801201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 120884) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA 091920) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 091920) | |
| 101YM0800X Counselor, Mental Health (Licence: CA 091920) | |
| 1041C0700X Social Worker, Clinical (Licence: CA 120884) | |
| 1041S0200X Social Worker, School (Licence: CA 120884) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2024-12-09 |