NPI | 1285728642 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: PA PC003641) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC003641) |
101YP2500X Counselor, Professional (Licence: PA PC003641) | |
Enumeration Date | 2006-10-02 |
Last Update Date | 2022-06-14 |