| NPI | 1326631334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA APCC12210) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: CA 12100) | |
| 101YM0800X Counselor, Mental Health (Licence: CA 12210) | |
| 101YP2500X Counselor, Professional (Licence: CA APCC12210) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2023-02-24 |