NPI | 1265068340 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN cc02400) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2020-03-20 |
Last Update Date | 2024-06-20 |