| NPI | 1487490439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA 12270) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA PE0031247) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2024-07-08 |
| Last Update Date | 2024-07-08 |