NPI | 1235628199 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 0015836) |
225A00000X Music Therapist (Licence: CO 13551) | |
Enumeration Date | 2018-05-07 |
Last Update Date | 2024-04-02 |