| NPI | 1427478726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180014640) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39004381A) |
| 101YP2500X Counselor, Professional (Licence: IL 180.014640) | |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2024-01-06 |