NPI | 1386122927 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 009943) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: HI 744) |
Enumeration Date | 2018-08-06 |
Last Update Date | 2023-06-22 |