NPI | 1578843710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC A8605) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A8605) |
Enumeration Date | 2011-08-19 |
Last Update Date | 2013-10-08 |