NPI | 1669974481 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK LPC07377) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OK LPC07377) |
Enumeration Date | 2018-03-07 |
Last Update Date | 2025-02-26 |