NPI | 1730512997 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 0003499) |
Additional Taxonomies | 251B00000X Case Management |
Enumeration Date | 2013-08-12 |
Last Update Date | 2016-05-25 |