| NPI | 1326729336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO 0020801) |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-07-31 |