NPI | 1396570321 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6451023897) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6451023897) |
Enumeration Date | 2024-09-09 |
Last Update Date | 2024-09-09 |