NPI | 1245696764 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH61089293) |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2016-01-13 |
Last Update Date | 2025-07-09 |