NPI | 1518482231 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C9929) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR R7205) |
Enumeration Date | 2017-08-03 |
Last Update Date | 2025-05-23 |