| NPI | 1437715471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: RI MCH01003) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101Y00000X Counselor | |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2025-07-29 |