NPI | 1215394499 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 14273) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 14273) |
Enumeration Date | 2016-01-19 |
Last Update Date | 2023-12-12 |