NPI | 1336222660 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 1820) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2006-10-23 |
Last Update Date | 2007-07-23 |