| NPI | 1467840959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TN 3910) |
| 101YP2500X Counselor, Professional (Licence: TX 84276) | |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2022-09-06 |