| NPI | 1366033243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 011102) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CT 5002) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH20643) | |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2024-02-27 |