NPI | 1265227201 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: IL 149.028942) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 149.028942) |
Enumeration Date | 2025-04-10 |
Last Update Date | 2025-04-10 |