NPI | 1760285563 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA PLC9987) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA PLM1531) |
Enumeration Date | 2025-03-28 |
Last Update Date | 2025-03-28 |