NPI | 1679829329 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH20178) |
Additional Taxonomies | 251B00000X Case Management |
Enumeration Date | 2012-07-31 |
Last Update Date | 2022-11-02 |