NPI | 1285277970 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 14934) |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
Enumeration Date | 2019-10-24 |
Last Update Date | 2024-05-18 |