NPI | 1770075335 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA APCC5161) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA APCC5161) |
Enumeration Date | 2018-05-30 |
Last Update Date | 2023-10-27 |