NPI | 1033374947 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 8644) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2008-07-21 |
Last Update Date | 2016-10-04 |