| NPI | 1437715489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 0018501) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPCC0017535) |
| 101YM0800X Counselor, Mental Health (Licence: CO 0017535) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2022-08-03 |