| NPI | 1407277668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC009028) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA APC004043) |
| 101YP2500X Counselor, Professional (Licence: GA 009028) | |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2022-01-04 |