NPI | 1356027171 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 285198) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C2204465) |
Enumeration Date | 2023-06-26 |
Last Update Date | 2023-06-26 |