NPI | 1992122253 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA PC007351) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC007351) |
Enumeration Date | 2014-03-25 |
Last Update Date | 2014-03-25 |