NPI | 1215013875 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: ME LC3852) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ME Lc 3852) |
Enumeration Date | 2006-10-27 |
Last Update Date | 2007-07-08 |