| NPI | 1851694491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ME xl3597) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor (Licence: ME 00067145) |
| Enumeration Date | 2010-12-20 |
| Last Update Date | 2010-12-20 |