NPI | 1619682655 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW115294) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW115294) |
171M00000X Case Manager/Care Coordinator | |
172V00000X Community Health Worker | |
Enumeration Date | 2023-01-13 |
Last Update Date | 2023-08-16 |