| NPI | 1467053884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE PMHP11626) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE P-1697) |
| 101YM0800X Counselor, Mental Health (Licence: NE PMSW7282) | |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2020-11-10 |