NPI | 1235995317 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL ISW19761) |
Enumeration Date | 2024-02-26 |
Last Update Date | 2024-06-18 |