NPI | 1194867689 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701005755) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 15632) |
101YP2500X Counselor, Professional (Licence: NM 0141561) | |
101YP2500X Counselor, Professional (Licence: CO LPC.0012900) | |
Enumeration Date | 2007-02-13 |
Last Update Date | 2024-07-17 |