NPI | 1780302570 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 107910) |
Additional Taxonomies | 104100000X Social Worker (Licence: TX 107910) |
Enumeration Date | 2022-08-17 |
Last Update Date | 2022-08-17 |