NPI | 1407744550 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 138346) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA 002093) |
Enumeration Date | 2025-06-26 |
Last Update Date | 2025-06-26 |