NPI | 1801436944 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC A15365) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A15365) |
Enumeration Date | 2020-01-07 |
Last Update Date | 2020-04-03 |