NPI | 1750540852 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: CA 98721) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 98721) |
390200000X Student in an Organized Health Care Education/Training Program | |
101Y00000X Counselor (Licence: CA 98721) | |
Enumeration Date | 2008-06-03 |
Last Update Date | 2023-09-15 |