| NPI | 1629541446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 20593) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 8361) |
| 101YM0800X Counselor, Mental Health (Licence: CA 20593) | |
| 101YP2500X Counselor, Professional (Licence: CA 8361) | |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2025-09-30 |