| NPI | 1437796190 |
|---|---|
| Former Name | COLLEEN HELEN DEHAIS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW1120294) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2024-12-18 |