NPI | 1497132450 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH13748) |
Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: FL 17022) |
Enumeration Date | 2015-04-29 |
Last Update Date | 2015-11-04 |