NPI | 1043434194 |
---|---|
Other Name | JIM MACKEY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0002991) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 2991) |
Enumeration Date | 2007-04-12 |
Last Update Date | 2018-03-20 |