| NPI | 1891222477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO NLC0106535) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO NLC0106535) |
| 101YP2500X Counselor, Professional (Licence: CO NLC0106535) | |
| 106H00000X Marriage & Family Therapist (Licence: CO NLC0106535) | |
| 225A00000X Music Therapist (Licence: CO NLC0106535) | |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2022-03-29 |