| NPI | 1841516424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 6441-125) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 6441-125) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2023-12-28 |