NPI | 1538445077 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN cc00242) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.0501253) |
Enumeration Date | 2011-10-28 |
Last Update Date | 2011-10-28 |