NPI | 1396578555 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 90013) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 90013) |
Enumeration Date | 2024-08-22 |
Last Update Date | 2024-09-03 |