NPI | 1710464011 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 100896) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 84515) |
104100000X Social Worker | |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2018-07-19 |
Last Update Date | 2021-09-13 |