NPI | 1932541315 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 10844181-6004) |
Additional Taxonomies | 253J00000X Foster Care Agency |
101YM0800X Counselor, Mental Health (Licence: UT 10844181-6009) | |
Enumeration Date | 2013-07-25 |
Last Update Date | 2023-10-04 |