NPI | 1780716910 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA ASW73971) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW17358) |
Enumeration Date | 2007-03-12 |
Last Update Date | 2017-02-03 |