NPI | 1023324613 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 10187) |
101YM0800X Counselor, Mental Health (Licence: FL 15484) | |
Enumeration Date | 2010-08-20 |
Last Update Date | 2023-12-21 |