| NPI | 1619266970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 347612) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101Y00000X Counselor | |
| 101YP1600X Counselor, Pastoral | |
| 101YS0200X Counselor, School (Licence: GA 1379346) | |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2016-10-10 |