NPI | 1417447616 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA 009617) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YM0800X Counselor, Mental Health (Licence: AL 3245) | |
101YM0800X Counselor, Mental Health (Licence: TN 3571) | |
Enumeration Date | 2018-05-14 |
Last Update Date | 2019-04-11 |