| NPI | 1043983190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC016445) |
| 101YM0800X Counselor, Mental Health (Licence: OH E.2404169) | |
| Enumeration Date | 2021-07-26 |
| Last Update Date | 2024-09-11 |