NPI | 1912088469 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KS LCPC 059) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 2893) |
101YM0800X Counselor, Mental Health (Licence: NE 3543) | |
Enumeration Date | 2006-10-18 |
Last Update Date | 2024-01-10 |