NPI | 1881229904 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ACSW93178) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ACSW93178) |
104100000X Social Worker (Licence: CA ACSW93178) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CA ACSW93178) | |
Enumeration Date | 2020-03-09 |
Last Update Date | 2021-04-30 |