NPI | 1538053038 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA LMHC10003684) |
Additional Taxonomies | 101200000X Drama Therapist (Licence: MA RDT891) |
Enumeration Date | 2025-06-07 |
Last Update Date | 2025-06-07 |