NPI | 1497367346 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR A2007097) |
Additional Taxonomies | 101Y00000X Counselor (Licence: AR A2007097) |
Enumeration Date | 2020-08-21 |
Last Update Date | 2020-10-05 |