NPI | 1447633839 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 281849) |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health (Licence: KY 281849) | |
Enumeration Date | 2015-07-02 |
Last Update Date | 2024-09-12 |