NPI | 1013643964 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 82856) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 82856) |
Enumeration Date | 2022-07-25 |
Last Update Date | 2024-02-26 |