NPI | 1780364943 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 13464) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NE 7874) |
Enumeration Date | 2023-07-24 |
Last Update Date | 2023-07-24 |