NPI | 1316668577 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 016253) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2022-09-07 |
Last Update Date | 2025-06-29 |