NPI | 1699184879 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 103914) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW77854) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2014-08-12 |
Last Update Date | 2021-09-16 |