| NPI | 1447282793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 7024) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-12205) |
| 101YM0800X Counselor, Mental Health (Licence: NM 0090071) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2008-09-25 |