NPI | 1013407618 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 7886) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 7886) |
Enumeration Date | 2018-05-18 |
Last Update Date | 2024-10-16 |