NPI | 1366004467 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSB94023768) |
Enumeration Date | 2019-06-28 |
Last Update Date | 2023-12-06 |