| NPI | 1699837617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE LIMHP357) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH61549149) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2024-10-01 |