NPI | 1558829457 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH61055500) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39003508A) |
101YM0800X Counselor, Mental Health (Licence: OR C5666) | |
Enumeration Date | 2019-03-10 |
Last Update Date | 2020-10-19 |