NPI | 1790979425 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YP2500X Counselor, Professional (Licence: TX 61716) | |
Enumeration Date | 2007-09-06 |
Last Update Date | 2022-02-16 |