NPI | 1871133660 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 126881) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
104100000X Social Worker (Licence: CA 102774) | |
Enumeration Date | 2020-01-09 |
Last Update Date | 2024-12-03 |