NPI | 1134866858 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 86807) |
Enumeration Date | 2022-05-14 |
Last Update Date | 2023-11-01 |