NPI | 1891522785 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 276311) |
Additional Taxonomies | 101Y00000X Counselor (Licence: KY 276311) |
Enumeration Date | 2024-09-16 |
Last Update Date | 2025-02-11 |