| NPI | 1770731465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW71902) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA D3981988) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2020-02-20 |