NPI | 1467830356 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0014742) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0014742) |
101YP1600X Counselor, Pastoral (Licence: KS 2969) | |
Enumeration Date | 2015-05-11 |
Last Update Date | 2022-05-12 |