NPI | 1982275517 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC11638) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC11638) |
101YP1600X Counselor, Pastoral (Licence: MD LC11638) | |
Enumeration Date | 2021-07-06 |
Last Update Date | 2021-08-23 |