NPI | 1720684459 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN cc03388) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2020-12-08 |
Last Update Date | 2023-02-02 |