NPI | 1457869034 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 17648) |
Enumeration Date | 2018-01-17 |
Last Update Date | 2024-03-25 |