NPI | 1891439683 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 109748) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NY 109748) |
Enumeration Date | 2022-04-26 |
Last Update Date | 2022-04-26 |