NPI | 1720481930 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NY P94437) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 007195) |
Enumeration Date | 2014-10-01 |
Last Update Date | 2016-08-22 |