NPI | 1922479807 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 131913) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 97393) |
390200000X Student in an Organized Health Care Education/Training Program | |
101YM0800X Counselor, Mental Health (Licence: CA 97393) | |
Enumeration Date | 2015-10-17 |
Last Update Date | 2025-07-23 |