NPI | 1508928680 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 3471) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NC 3471) |
Enumeration Date | 2006-12-14 |
Last Update Date | 2015-12-02 |