NPI | 1609541010 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 95952) |
Enumeration Date | 2021-08-09 |
Last Update Date | 2023-06-27 |