NPI | 1215929450 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 957) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NE 686) |
Enumeration Date | 2005-08-15 |
Last Update Date | 2007-11-19 |