| NPI | 1427709484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: HI MHC-833) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C11292) |
| 101YM0800X Counselor, Mental Health (Licence: WA MHC.LH.70094769) | |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2026-09-02 |