NPI | 1821716119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 132372) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW108952) |
1041C0700X Social Worker, Clinical (Licence: CA ASW108952) | |
Enumeration Date | 2022-08-22 |
Last Update Date | 2025-07-25 |