NPI | 1205316601 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR A1609122) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR F1609014) |
Enumeration Date | 2018-08-16 |
Last Update Date | 2018-08-16 |