NPI | 1699397596 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA APCC7454) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 7454) |
Enumeration Date | 2020-05-13 |
Last Update Date | 2022-08-29 |