NPI | 1841895976 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 005675) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling |
Enumeration Date | 2020-12-04 |
Last Update Date | 2024-10-11 |