NPI | 1215375787 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 68161) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TX 68161) |
Enumeration Date | 2013-06-06 |
Last Update Date | 2024-07-15 |