| NPI | 1922448885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 1858-226) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16612-130) |
| 101YP1600X Counselor, Pastoral | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2014-06-25 |