NPI | 1457046963 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6451022209) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6451022209) |
Enumeration Date | 2023-04-10 |
Last Update Date | 2024-02-23 |