NPI | 1790979425 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60522224) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 61716) |
101YM0800X Counselor, Mental Health | |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2007-09-06 |
Last Update Date | 2024-11-04 |