| NPI | 1144578238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39003306A) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH12360) | |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2025-04-15 |