NPI | 1487226734 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180013798) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178014196) |
Enumeration Date | 2021-07-15 |
Last Update Date | 2023-05-19 |