NPI | 1316103898 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180008827) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C9781) |
101YP2500X Counselor, Professional (Licence: OR C9781) | |
101YP2500X Counselor, Professional (Licence: IL 180008827) | |
Enumeration Date | 2008-08-04 |
Last Update Date | 2025-06-03 |