| NPI | 1326820267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC016152) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 11835-125) |
| 101YM0800X Counselor, Mental Health (Licence: ID 1671134) | |
| 101YP2500X Counselor, Professional (Licence: MD LC16391) | |
| 101YP2500X Counselor, Professional (Licence: SC TLC1706PC) | |
| 101YM0800X Counselor, Mental Health (Licence: FL TPMC4876) | |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2026-03-13 |