NPI | 1245935956 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C008633) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC C008633) |
101YP2500X Counselor, Professional | |
Enumeration Date | 2023-04-03 |
Last Update Date | 2023-04-03 |