NPI | 1861043994 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ME CC6632) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ME CC6632) |
Enumeration Date | 2019-09-20 |
Last Update Date | 2025-04-02 |