NPI | 1477767762 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C2273) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C2273) |
Enumeration Date | 2007-05-09 |
Last Update Date | 2022-02-03 |