NPI | 1225433535 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 64921) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TX 64921) |
101YM0800X Counselor, Mental Health (Licence: TX 64921) | |
Enumeration Date | 2014-10-29 |
Last Update Date | 2014-10-29 |