NPI | 1306479910 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: PA PC010138) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: PA PC010138) |
101YP2500X Counselor Professional (Licence: DE PC-0000979) | |
Enumeration Date | 2020-02-21 |
Last Update Date | 2024-03-28 |