NPI | 1396336236 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 93617) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 013487) |
Enumeration Date | 2021-02-02 |
Last Update Date | 2024-10-10 |