| NPI | 1538546775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401010514) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: MI SC0000692) |
| 225C00000X Rehabilitation Counselor (Licence: 00101760) | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2016-05-07 |