NPI | 1043718737 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 16627) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YP2500X Counselor, Professional | |
225400000X Rehabilitation Practitioner | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-01-27 |
Last Update Date | 2024-09-04 |