| 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 |