NPI | 1649059338 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 119517) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 119517) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2023-09-22 |
Last Update Date | 2024-04-24 |