| NPI | 1689269631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 117787) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 100803) |
| 104100000X Social Worker (Licence: CA 100803) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2021-03-02 |
| Last Update Date | 2024-09-10 |