NPI | 1821360264 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: P1608121) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2012-02-01 |
Last Update Date | 2021-09-03 |