| NPI | 1336247196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KS LCPC 096) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KS LCPC096) |
| 101YM0800X Counselor, Mental Health (Licence: KS LCPC096) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2024-12-10 |