NPI | 1801341565 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 002791) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 006102-1) |
Enumeration Date | 2016-08-23 |
Last Update Date | 2016-08-23 |