NPI | 1114572146 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC011393) |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2019-08-06 |
Last Update Date | 2019-08-06 |