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Individual
MR. SIDARY SAM
Active
Individual
MR. SIDARY SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
ASW 22278
CA
1041C0700X
Clinical Social Worker
Primary
LCSW94013
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/23/2007
Last updated
03/08/2021
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