NPI | 1962043620 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW126156) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW85848) |
Enumeration Date | 2019-10-03 |
Last Update Date | 2025-02-25 |