NPI | 1841632528 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 684-5-1-11-256) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ND 684-5-1-11-256) |
Enumeration Date | 2013-07-23 |
Last Update Date | 2016-09-12 |