NPI | 1215405121 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2018-11-08 |
Last Update Date | 2024-11-19 |