NPI | 1669567285 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA none required) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: none required) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2007-07-08 |