NPI | 1770195042 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 89189) |
1041C0700X Social Worker, Clinical (Licence: CA 89189) | |
Enumeration Date | 2020-08-18 |
Last Update Date | 2025-09-18 |