NPI | 1134604481 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 75610) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2018-10-02 |
Last Update Date | 2025-02-04 |