NPI | 1730730334 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.2001785-SUPV) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL TPMC1063) |
101YM0800X Counselor, Mental Health (Licence: PA PC013553) | |
Enumeration Date | 2019-09-25 |
Last Update Date | 2021-08-03 |