NPI | 1275825630 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 83351) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2011-05-04 |
Last Update Date | 2024-07-25 |