| NPI | 1629338058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 117338) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2023-12-26 |