NPI | 1740840933 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 6496) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 6496) |
Enumeration Date | 2019-06-19 |
Last Update Date | 2023-08-29 |