| NPI | 1447680574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180008936) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178007901) |
| 101YP2500X Counselor, Professional (Licence: IL 180008936) | |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2014-01-14 |