NPI | 1689192239 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC A13138) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A13138) |
Enumeration Date | 2017-09-05 |
Last Update Date | 2022-07-21 |