| NPI | 1639517188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CA ASW86634) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA 86634) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2021-02-23 |