| NPI | 1285477414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling |
| Additional Taxonomies | 101YP1600X Counselor Pastoral |
| 103TS0200X Psychologist School | |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2024-06-15 |
| Last Update Date | 2024-06-15 |