NPI | 1780093849 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH9636) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL MH9636) |
Enumeration Date | 2014-08-03 |
Last Update Date | 2024-03-07 |