| NPI | 1134475197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 6651) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2018-04-09 |