NPI | 1568616118 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 4694) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY KY 1667) |
101YM0800X Counselor, Mental Health (Licence: KY 104445) | |
Enumeration Date | 2008-11-10 |
Last Update Date | 2021-11-10 |