NPI | 1760020903 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0022402) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 0022402) |
Enumeration Date | 2019-12-18 |
Last Update Date | 2025-08-07 |