NPI | 1457839797 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: HI MHC249) |
101YM0800X Counselor, Mental Health (Licence: NM CCMH0195201) | |
Enumeration Date | 2018-07-30 |
Last Update Date | 2018-07-30 |