NPI | 1477826089 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 25930) |
Enumeration Date | 2012-02-13 |
Last Update Date | 2012-03-01 |