NPI | 1144773011 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: NC 4927) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2011009699) |
Enumeration Date | 2016-07-27 |
Last Update Date | 2016-07-27 |