NPI | 1497108872 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 6240769-6004) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 13317) |
101YM0800X Counselor, Mental Health (Licence: NJ 37PC00936800) | |
101YM0800X Counselor, Mental Health (Licence: NY 014689) | |
101YM0800X Counselor, Mental Health (Licence: MA LMHC10003114) | |
Enumeration Date | 2016-07-20 |
Last Update Date | 2024-11-11 |