NPI | 1952689218 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: DE PC0000556) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: DE PC0000556) |
Enumeration Date | 2011-08-03 |
Last Update Date | 2011-08-03 |