| NPI | 1558310235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 1587) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL MH 1587) |
| 101Y00000X Counselor (Licence: FL MH 1587) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2007-10-30 |