NPI | 1306593439 |
---|---|
Former Name | STEFAN CHASE ENTLER |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 83394) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OR C10285) |
101YP2500X Counselor Professional (Licence: MT 72354) | |
Enumeration Date | 2022-03-08 |
Last Update Date | 2025-08-14 |