| NPI | 1679461826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 221700000X Art Therapist |
| 225A00000X Music Therapist | |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2025-06-26 |