| NPI | 1568209039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 221700000X Art Therapist |
| 225A00000X Music Therapist | |
| Enumeration Date | 2024-07-11 |
| Last Update Date | 2024-07-11 |