| NPI | 1689148355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 129141) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW84215) |
| 225400000X Rehabilitation Practitioner | |
| 101YM0800X Counselor, Mental Health | |
| 104100000X Social Worker | |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2025-05-07 |