NPI | 1326162967 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: 81648) |
Additional Taxonomies | 101Y00000X Counselor (Licence: 3105) |
101YM0800X Counselor, Mental Health (Licence: 81648) | |
Enumeration Date | 2007-03-19 |
Last Update Date | 2025-09-11 |