NPI | 1720592793 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C5526) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2017-11-28 |
Last Update Date | 2020-11-23 |