NPI | 1558246322 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A19002) |
Additional Taxonomies | 225C00000X Rehabilitation Counselor (Licence: 369300) |
Enumeration Date | 2025-08-09 |
Last Update Date | 2025-08-09 |