NPI | 1003138710 |
---|---|
Former Name | TREBOR WELLINGTON BOSLEY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2010088) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2010-02-22 |
Last Update Date | 2021-04-29 |