| NPI | 1487076493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.2303894) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60891645) |
| Enumeration Date | 2014-01-09 |
| Last Update Date | 2024-09-24 |