NPI | 1932556701 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
101YM0800X Counselor Mental Health | |
Enumeration Date | 2016-05-20 |
Last Update Date | 2021-05-06 |