NPI | 1821734450 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: LA 00000) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 00000) |
Enumeration Date | 2022-05-06 |
Last Update Date | 2022-05-09 |