NPI | 1427544030 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C6292) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2018-07-06 |
Last Update Date | 2024-12-04 |