| NPI | 1477847457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 0005968) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 5968) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2021-05-19 |