| NPI | 1851528012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401004268) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MI 6301007205) |
| 104100000X Social Worker (Licence: MI 6801063013) | |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2009-06-16 |