NPI | 1831733740 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN LPCC2226) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NE LIMHP3440) |
101YP2500X Counselor, Professional (Licence: MN LPCC2226) | |
101YP2500X Counselor, Professional (Licence: NE CPC2867) | |
101YM0800X Counselor, Mental Health (Licence: NE LIMHP3440) | |
Enumeration Date | 2019-11-04 |
Last Update Date | 2024-10-30 |