NPI | 1356782759 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180008841) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178007453) |
Enumeration Date | 2013-07-13 |
Last Update Date | 2014-01-17 |