| NPI | 1528574522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 011035) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 1528574522) |
| 101YM0800X Counselor, Mental Health (Licence: NY P08625) | |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2024-07-26 |