NPI | 1659336675 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NE 1170) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 2041) |
Enumeration Date | 2006-04-20 |
Last Update Date | 2007-07-08 |