NPI | 1962232884 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DC LGPC200001681) |
Additional Taxonomies | 101Y00000X Counselor (Licence: DC LGPC200001681) |
101YM0800X Counselor, Mental Health (Licence: DC LGPC200001681) | |
Enumeration Date | 2024-08-05 |
Last Update Date | 2024-08-05 |