NPI | 1740858299 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA LPCC20273) |
Additional Taxonomies | 101YP1600X Counselor, Pastoral |
101YM0800X Counselor, Mental Health (Licence: CA LPCC20273) | |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA LPCC20273) | |
Enumeration Date | 2021-06-11 |
Last Update Date | 2025-09-20 |