NPI | 1821627134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ 22998) |
Additional Taxonomies | 101Y00000X Counselor (Licence: AZ 22998) |
101YM0800X Counselor Mental Health (Licence: AZ 22998) | |
Enumeration Date | 2020-04-07 |
Last Update Date | 2024-06-05 |