NPI | 1568503506 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 62681) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TX 62681) |
101YM0800X Counselor, Mental Health (Licence: TX 62681) | |
Enumeration Date | 2007-02-11 |
Last Update Date | 2008-07-10 |