NPI | 1992947295 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 73817) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA 73817) |
1041C0700X Social Worker, Clinical (Licence: CA 73817) | |
Enumeration Date | 2009-04-01 |
Last Update Date | 2021-12-20 |