NPI | 1508034208 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: RI MHC00446) |
Additional Taxonomies | 101Y00000X Counselor (Licence: RI 167) |
Enumeration Date | 2008-02-15 |
Last Update Date | 2013-04-25 |