| NPI | 1306914387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 104100000X Social Worker |
| 225A00000X Music Therapist | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2022-03-21 |