NPI | 1528839156 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS LPC04571) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KS LPC04571) |
Enumeration Date | 2024-01-11 |
Last Update Date | 2025-02-19 |