| NPI | 1518730639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 18275) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA 61480738) |
| Enumeration Date | 2023-10-31 |
| Last Update Date | 2025-02-12 |