NPI | 1457365058 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 914) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 00813) |
Enumeration Date | 2006-07-28 |
Last Update Date | 2016-09-29 |