| NPI | 1871731711 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: IN 930784)  | 
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2009-01-30 | 
| Last Update Date | 2025-02-26 |