NPI | 1710151030 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 63898) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 63898) |
Enumeration Date | 2008-04-17 |
Last Update Date | 2010-04-29 |