NPI | 1487098224 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 3429) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YM0800X Counselor, Mental Health (Licence: CA LPCC3429) | |
Enumeration Date | 2013-04-23 |
Last Update Date | 2024-10-18 |