| NPI | 1427569276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 7438) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A13361) |
| 101YM0800X Counselor, Mental Health (Licence: SC 7438) | |
| 101YP2500X Counselor, Professional (Licence: NC A13361) | |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2024-06-28 |