NPI | 1790985042 |
---|---|
Former Name | MICKI ANN WILLIAMS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW73368) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA ASW24005) |
101Y00000X Counselor | |
101YM0800X Counselor, Mental Health (Licence: CA ASW 62549) | |
104100000X Social Worker (Licence: CA ASW 62549) | |
Enumeration Date | 2007-07-24 |
Last Update Date | 2021-05-11 |