NPI | 1922240555 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ME CC349) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH6490) |
Enumeration Date | 2009-03-27 |
Last Update Date | 2009-03-27 |