| NPI | 1881071488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DC LGPC00032) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DC PRC14891) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2017-01-30 |