NPI | 1447577002 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MS 1633) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2010-04-22 |
Last Update Date | 2016-08-26 |