| NPI | 1851388946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 000425) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 0000425) |
| 101YM0800X Counselor, Mental Health (Licence: MO 000425) | |
| 101YS0200X Counselor, School | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2024-10-31 |