NPI | 1457909608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A14186) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NC A14186) |
Enumeration Date | 2019-08-30 |
Last Update Date | 2021-12-06 |