NPI | 1225712581 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 137666) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2023-06-14 |
Last Update Date | 2023-06-14 |