NPI | 1568185205 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DC PRC200002070) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2022-09-19 |
Last Update Date | 2024-07-08 |