NPI | 1073758892 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C4750) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60169232) |
101YP2500X Counselor, Professional | |
101YP2500X Counselor, Professional | |
Enumeration Date | 2008-12-08 |
Last Update Date | 2018-01-08 |