NPI | 1407355225 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.001051) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2018-02-07 |
Last Update Date | 2024-10-04 |