NPI | 1366014920 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 10594) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 10594) |
Enumeration Date | 2021-07-13 |
Last Update Date | 2024-03-11 |