NPI | 1023165131 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 7668) |
Enumeration Date | 2007-01-04 |
Last Update Date | 2024-02-19 |