NPI | 1487299665 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL ISW13200) |
Enumeration Date | 2019-11-12 |
Last Update Date | 2020-10-03 |