NPI | 1700410024 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 15598) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A15598) |
Enumeration Date | 2020-02-25 |
Last Update Date | 2022-06-24 |