NPI | 1568850105 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC009882) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC009882) |
Enumeration Date | 2015-01-06 |
Last Update Date | 2023-11-02 |