| NPI | 1730866641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA APC008924) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA APC008924) |
| 101YM0800X Counselor Mental Health (Licence: GA APC008924) | |
| 101YS0200X Counselor School | |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2023-07-03 |