NPI | 1639646540 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW96335) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: 96335) |
101YM0800X Counselor, Mental Health (Licence: CA 96335) | |
1041C0700X Social Worker, Clinical (Licence: CA 96335) | |
Enumeration Date | 2018-10-29 |
Last Update Date | 2024-02-14 |