| NPI | 1760494108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180-001565) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: IL 180-001565) |
| 101YP2500X Counselor, Professional (Licence: IL 180-001565) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2022-07-21 |