| NPI | 1932236510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA LCS23495) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA LCS23495) |
| 101YM0800X Counselor Mental Health (Licence: CA LCS23495) | |
| 101YP1600X Counselor Pastoral (Licence: CA LCS23495) | |
| 1041S0200X Social Worker School (Licence: CA LCS23495) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2011-04-05 |