| NPI | 1740591460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor (Licence: CA 2012306) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2020-05-21 |