| NPI | 1477761245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH5920) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL MH5920) |
| 101YP2500X Counselor, Professional (Licence: FL MH5920) | |
| 101YP1600X Counselor, Pastoral (Licence: FL MH5920) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2008-03-12 |