NPI | 1043854557 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C9885) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2019-10-29 |
Last Update Date | 2025-04-28 |