NPI | 1821496399 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 11341) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A11341) |
Enumeration Date | 2014-12-15 |
Last Update Date | 2022-09-22 |