NPI | 1437445954 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: LA 3975) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 3975) |
Enumeration Date | 2011-06-23 |
Last Update Date | 2013-10-31 |