| NPI | 1801564554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.016569) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.016354) |
| 101YM0800X Counselor, Mental Health (Licence: IL 178016354) | |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2024-12-27 |