NPI | 1023406865 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 12904) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2015-01-01 |
Last Update Date | 2021-10-27 |