NPI | 1780258731 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 3279) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 3279) |
101YP2500X Counselor, Professional (Licence: MN 01966) | |
Enumeration Date | 2021-05-14 |
Last Update Date | 2022-04-13 |