NPI | 1467007054 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC9479) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC9479) |
Enumeration Date | 2019-08-09 |
Last Update Date | 2019-08-09 |