| NPI | 1720273352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 11222) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 3641) |
| 101YP2500X Counselor, Professional (Licence: TN LPC1461) | |
| 101YP2500X Counselor, Professional (Licence: AZ 18090) | |
| 101YP2500X Counselor, Professional (Licence: NV CP2996-R) | |
| 101YP2500X Counselor, Professional (Licence: GA 010014) | |
| 101YP2500X Counselor, Professional (Licence: FL 3641) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2023-08-11 |