NPI | 1568070811 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN cc03766) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN cc03766) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-07-22 |
Last Update Date | 2024-03-26 |