NPI | 1962605469 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA ASW 24131) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2007-06-11 |
Last Update Date | 2013-05-13 |