| NPI | 1447584461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO 11389) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO 11389) |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2021-03-25 |