| NPI | 1851641237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AR P1506062) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AR P1506062) |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2016-08-25 |