| NPI | 1437996295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA PC019165) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA APC000150) |
| 101YM0800X Counselor, Mental Health (Licence: PA APC000150) | |
| 101YP2500X Counselor, Professional (Licence: PA APC000150) | |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2025-08-19 |