NPI | 1548926579 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 178.017005) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178.017005) |
Enumeration Date | 2021-11-15 |
Last Update Date | 2021-11-15 |