| NPI | 1881973378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A8657) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC A8657) |
| 101YP2500X Counselor, Professional (Licence: NC A8657) | |
| 225C00000X Rehabilitation Counselor | |
| 251S00000X (Licence: NC S8657) | |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2022-07-01 |