| NPI | 1376069294 |
|---|---|
| Former Name | KAIRALY SADANAM DEKSHINAMOORTHY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC008255) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA C0108) |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2022-07-21 |