| NPI | 1710207642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-19682) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ID LCPC-8338) |
| 101YP2500X Counselor, Professional (Licence: TX 87076) | |
| 101YM0800X Counselor, Mental Health (Licence: UT 13032711-6004) | |
| 101YM0800X Counselor, Mental Health (Licence: NM t-0132311) | |
| 101YM0800X Counselor, Mental Health (Licence: WA LH61207170) | |
| 101YP2500X Counselor, Professional (Licence: CO LPC.0017577) | |
| 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-50082) | |
| 101YP2500X Counselor, Professional (Licence: PA PC014150) | |
| 101YP2500X Counselor, Professional (Licence: OR C6387) | |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2023-05-16 |