NPI | 1861979494 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: A1711322) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AR P2008051) |
Enumeration Date | 2018-07-26 |
Last Update Date | 2020-08-17 |