NPI | 1609025923 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DE 000369) |
Additional Taxonomies | 101Y00000X Counselor (Licence: DE 000369) |
Enumeration Date | 2008-09-10 |
Last Update Date | 2008-09-10 |