| NPI | 1881217206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180014215) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 178-015547) |
| 101YM0800X Counselor, Mental Health (Licence: IL 180.014215) | |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2025-09-30 |