NPI | 1750914792 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NV 10050-M) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2020-02-18 |
Last Update Date | 2022-06-07 |