NPI | 1851471395 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DE PC-0000043) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DE 0000043) |
Enumeration Date | 2006-10-17 |
Last Update Date | 2018-08-20 |