| NPI | 1659832186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 113585) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2023-06-16 |