| NPI | 1689783482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TN LPC1838) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TN LPC1838) |
| 104100000X Social Worker (Licence: TN LPC 1838) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2024-02-19 |