NPI | 1669053633 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: CA 98436) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 98436) |
Enumeration Date | 2021-04-20 |
Last Update Date | 2024-01-23 |