NPI | 1447345970 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 7259) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 19380) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2008-12-20 |