NPI | 1821258252 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS27878) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2008-06-10 |
Last Update Date | 2023-05-12 |