| NPI | 1821114232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW107235) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 101YM0800X Counselor, Mental Health (Licence: CA ASW84593) | |
| 1041C0700X Social Worker, Clinical (Licence: CA ASW84593) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2023-02-02 |