NPI | 1932744729 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2103274) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OH C1902154) |
101Y00000X Counselor (Licence: OH APP000279573) | |
Enumeration Date | 2019-11-15 |
Last Update Date | 2021-04-28 |