NPI | 1417404476 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 104100000X Social Worker |
1041C0700X Social Worker, Clinical | |
Enumeration Date | 2016-09-07 |
Last Update Date | 2022-06-01 |