NPI | 1245546282 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 8075) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NC 8075) |
101YM0800X Counselor, Mental Health (Licence: NC 8075) | |
Enumeration Date | 2010-08-27 |
Last Update Date | 2010-08-27 |