NPI | 1649416884 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C2178) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OR C2178) |
Enumeration Date | 2008-12-17 |
Last Update Date | 2023-12-29 |