NPI | 1013211986 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: UT 6773106-6009) |
Additional Taxonomies | 101Y00000X Counselor (Licence: UT 6773106-6009) |
101YM0800X Counselor, Mental Health (Licence: UT 6773106-6009) | |
Enumeration Date | 2011-01-06 |
Last Update Date | 2011-01-06 |