NPI | 1386880714 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 001686) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 9087) |
Enumeration Date | 2009-01-07 |
Last Update Date | 2009-01-07 |