| NPI | 1821693482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL ISW13431) |
| Additional Taxonomies | 104100000X Social Worker (Licence: FL ISW13431) |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2020-12-02 |