| NPI | 1760637219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701007739) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: DC PRC15236) |
| 101YP2500X Counselor, Professional (Licence: MD LC10487) | |
| 101YM0800X Counselor, Mental Health (Licence: IN 39003460A) | |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2025-12-08 |