| NPI | 1871484493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 24244) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL 24244) |
| 101YS0200X Counselor, School (Licence: FL 1285142) | |
| Enumeration Date | 2025-07-11 |
| Last Update Date | 2025-07-11 |