NPI | 1245381508 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DE Q1-0000617) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000617) |
Enumeration Date | 2007-01-15 |
Last Update Date | 2012-01-19 |