NPI | 1982286498 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 13266) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 4244) |
Enumeration Date | 2021-04-23 |
Last Update Date | 2023-02-22 |