NPI | 1659524809 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0011395) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2008-10-31 |
Last Update Date | 2016-03-31 |