NPI | 1992375927 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 19939) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH21096) |
Enumeration Date | 2021-06-30 |
Last Update Date | 2022-08-06 |