NPI | 1306372263 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1701) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NE 50) |
Enumeration Date | 2017-05-11 |
Last Update Date | 2017-05-11 |