NPI | 1558675454 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 001310) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 001310) |
101YM0800X Counselor, Mental Health (Licence: CT 001310) | |
101YS0200X Counselor, School (Licence: CT 001310) | |
106H00000X Marriage & Family Therapist (Licence: CT 001310) | |
Enumeration Date | 2010-08-03 |
Last Update Date | 2010-08-03 |