NPI | 1619359783 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: CA 71673) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
101YM0800X Counselor, Mental Health | |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2015-06-24 |
Last Update Date | 2016-09-26 |