NPI | 1356951388 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LH60992581) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA MC610484) |
101YS0200X Counselor School (Licence: WA 565032J) | |
Enumeration Date | 2020-08-04 |
Last Update Date | 2023-09-18 |