NPI | 1013343938 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 5934) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 91590) |
Enumeration Date | 2013-09-24 |
Last Update Date | 2025-09-08 |