| NPI | 1144459207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TN LPC0000001847) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: GA LPC005219) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2009-07-10 |