NPI | 1962216309 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: CA APCC18238) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA APCC18238) |
Enumeration Date | 2025-02-05 |
Last Update Date | 2025-02-26 |