NPI | 1356853998 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA lh61019706) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2017-11-03 |
Last Update Date | 2020-03-02 |