NPI | 1396022075 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0013970) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CO NLC 0104553) |
101Y00000X Counselor (Licence: AR A1101005) | |
Enumeration Date | 2011-11-09 |
Last Update Date | 2023-08-16 |