| NPI | 1811410020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW128570) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 102790) |
| 104100000X Social Worker | |
| 225400000X Rehabilitation Practitioner | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2025-02-24 |