NPI | 1275909889 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2023031673) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KS 03303) |
101YP2500X Counselor, Professional (Licence: NV CP0227) | |
104100000X Social Worker (Licence: KS 12971) | |
104100000X Social Worker (Licence: NV 10247-M) | |
Enumeration Date | 2015-08-18 |
Last Update Date | 2023-08-14 |