NPI | 1790163442 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 111557) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 111557) |
103K00000X Behavior Analyst | |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2015-05-14 |
Last Update Date | 2023-07-03 |