NPI | 1265807952 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 008386) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2015-12-06 |
Last Update Date | 2018-06-04 |