NPI | 1659011195 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101Y00000X Counselor |
101YP2500X Counselor, Professional | |
Enumeration Date | 2022-03-31 |
Last Update Date | 2022-03-31 |