NPI | 1801662754 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA SC61501042) |
Additional Taxonomies | 104100000X Social Worker (Licence: WA SC61501042) |
Enumeration Date | 2023-12-01 |
Last Update Date | 2025-05-29 |