NPI | 1659469963 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 2522) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NE 1371) |
Enumeration Date | 2006-10-11 |
Last Update Date | 2007-07-08 |