NPI | 1215045687 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC005523) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 001726) |
Enumeration Date | 2006-08-27 |
Last Update Date | 2024-08-12 |