NPI | 1235416033 |
---|---|
Other Name | BO JOHNSON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 64947) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2011-11-08 |
Last Update Date | 2024-02-07 |