NPI | 1235431925 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C3884) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C3884) |
101YM0800X Counselor, Mental Health | |
101YP2500X Counselor, Professional | |
Enumeration Date | 2010-12-01 |
Last Update Date | 2023-06-08 |