| NPI | 1023302049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AL 1736) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health | |
| 101YP1600X Counselor Pastoral | |
| 101YS0200X Counselor School | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2011-06-07 |