NPI | 1851345276 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: DE PC-00001) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LC-0209) |
Enumeration Date | 2006-05-20 |
Last Update Date | 2009-05-19 |