NPI | 1639832702 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 123200) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 105344) |
1041C0700X Social Worker, Clinical (Licence: CA 105344) | |
225400000X Rehabilitation Practitioner | |
104100000X Social Worker (Licence: CA 105344) | |
Enumeration Date | 2021-10-15 |
Last Update Date | 2024-07-17 |