NPI | 1851843437 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 73414) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TX 73414) |
101YP2500X Counselor, Professional (Licence: TX 73414) | |
Enumeration Date | 2016-10-28 |
Last Update Date | 2024-09-12 |