NPI | 1457816951 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 89031) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 89031) |
Enumeration Date | 2019-02-08 |
Last Update Date | 2025-08-14 |