NPI | 1427265719 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: KY 0888) |
Additional Taxonomies | 221700000X Art Therapist (Licence: KY 05-029) |
Enumeration Date | 2007-05-17 |
Last Update Date | 2007-07-08 |