NPI | 1821568189 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC11093) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MD LC11093) |
101YP1600X Counselor, Pastoral (Licence: MD LC11093) | |
101YP2500X Counselor, Professional (Licence: MD LC11093) | |
Enumeration Date | 2018-11-29 |
Last Update Date | 2021-01-21 |