NPI | 1386985034 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC4471) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2013-03-05 |
Last Update Date | 2016-09-27 |