NPI | 1245523125 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 5796) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2011-05-25 |
Last Update Date | 2024-06-04 |