NPI | 1962662452 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 7500) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2008-06-10 |
Last Update Date | 2009-11-30 |