NPI | 1437359130 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 65426) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2007-07-20 |
Last Update Date | 2017-11-18 |