| NPI | 1295412153 |
|---|---|
| Former Name | ROBERT DICK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-22252) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LPC-22252) |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2023-07-13 |