NPI | 1215400502 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: APCC9330) |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2019-01-09 |
Last Update Date | 2024-05-23 |