NPI | 1992951545 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 6992) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 6992) |
Enumeration Date | 2008-08-14 |
Last Update Date | 2012-09-07 |