| NPI | 1982012423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TN 2443) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TN 2443) |
| 101YP2500X Counselor Professional (Licence: TN 002443) | |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2019-08-02 |