NPI | 1669132023 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NV CP5475-R) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701010755) |
101YP2500X Counselor, Professional (Licence: GA LPC008584) | |
101YP2500X Counselor, Professional (Licence: CA LPCC11502) | |
Enumeration Date | 2021-12-28 |
Last Update Date | 2023-11-09 |