NPI | 1407005416 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DC LC300557) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD 13575) |
Enumeration Date | 2008-09-15 |
Last Update Date | 2013-02-27 |