NPI | 1083437966 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 11088) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 4635) |
Enumeration Date | 2024-11-07 |
Last Update Date | 2024-11-07 |