| NPI | 1598130841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 180.005419) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180.005419) |
| 101YP1600X Counselor, Pastoral (Licence: IL 180.005419) | |
| 101YP2500X Counselor, Professional (Licence: IL 180.005419) | |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2015-12-10 |