NPI | 1902153646 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA IMF 70630) |
Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: RI 3202) |
Enumeration Date | 2012-08-13 |
Last Update Date | 2012-08-13 |