NPI | 1609929173 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM LPCC 1047) |
Enumeration Date | 2007-01-19 |
Last Update Date | 2017-09-07 |