NPI | 1568635407 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 2565) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 61480) |
101YP2500X Counselor, Professional (Licence: TX 61480) | |
Enumeration Date | 2008-04-11 |
Last Update Date | 2022-08-18 |