NPI | 1427346840 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 103249) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2011-07-19 |
Last Update Date | 2021-03-25 |