NPI | 1598387706 |
---|---|
Former Name | CHRISTOPHER W BOYLAN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN cc02166) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60201099) |
Enumeration Date | 2020-05-11 |
Last Update Date | 2020-05-13 |