NPI | 1588833479 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: TN PE0000001755) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TN LPC0000000416) |
Enumeration Date | 2008-02-25 |
Last Update Date | 2008-02-25 |