NPI | 1003282625 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2233) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 5027) |
Enumeration Date | 2015-08-18 |
Last Update Date | 2019-11-22 |