NPI | 1730278854 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM 0100411) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM 0100411) |
Enumeration Date | 2006-10-12 |
Last Update Date | 2015-10-15 |