NPI | 1215058334 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 7810) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YP2500X Counselor, Professional | |
101YP2500X Counselor, Professional (Licence: CA 2774) | |
Enumeration Date | 2007-04-03 |
Last Update Date | 2020-05-04 |