NPI | 1760806996 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MS 1601) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MS 1601) |
Enumeration Date | 2014-02-07 |
Last Update Date | 2022-02-17 |