NPI | 1447578638 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA LMHC) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2010-05-12 |
Last Update Date | 2020-11-16 |