NPI | 1033125331 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 14429) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2006-07-31 |
Last Update Date | 2024-09-24 |