| NPI | 1801541511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 8519497-6004) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 8519497-6101) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2024-05-20 |