| NPI | 1447897293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA PC016562) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.2303373) |
| Enumeration Date | 2019-11-27 |
| Last Update Date | 2024-04-02 |