NPI | 1144292376 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH21677) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC004011) |
Enumeration Date | 2006-02-02 |
Last Update Date | 2025-03-25 |