NPI | 1235779182 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 79184) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TX 79184) |
101YP1600X Counselor, Pastoral (Licence: TX 79184) | |
101YP2500X Counselor, Professional (Licence: TX 79184) | |
Enumeration Date | 2020-01-08 |
Last Update Date | 2020-01-08 |