NPI | 1437665759 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 5312) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NE 2515) |
Enumeration Date | 2017-12-21 |
Last Update Date | 2024-02-07 |