NPI | 1821778770 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TS0200X Psychologist, School (Licence: CA 4374) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 104053) |
Enumeration Date | 2023-07-24 |
Last Update Date | 2023-07-24 |