NPI | 1821637406 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NV ci740) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NV ci740) |
101YM0800X Counselor, Mental Health (Licence: NV ci740) | |
Enumeration Date | 2019-12-31 |
Last Update Date | 2019-12-31 |