| NPI | 1447828421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY LPC-2135) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WY PPC-1259) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2023-02-01 |