NPI | 1386004679 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 89721) |
Additional Taxonomies | 101Y00000X Counselor |
225C00000X Rehabilitation Counselor | |
Enumeration Date | 2016-02-29 |
Last Update Date | 2025-08-13 |