NPI | 1831634641 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 2112) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2017-01-03 |
Last Update Date | 2019-06-29 |