| NPI | 1336981380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA MF000975) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DE FT-0010090) |
| 101YM0800X Counselor, Mental Health (Licence: NJ 37FI00205500) | |
| 101YM0800X Counselor, Mental Health (Licence: FL TPMF1117) | |
| 101YM0800X Counselor, Mental Health (Licence: NY 002255) | |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2024-06-11 |