| NPI | 1003879339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NY 06-000025) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 18-000086) |
| 101YP2500X Counselor, Professional (Licence: VA 0701001436) | |
| 146N00000X Emergency Medical Technician, Basic (Licence: NY 345528) | |
| 106H00000X Marriage & Family Therapist (Licence: VA 0701000134) | |
| 101YM0800X Counselor, Mental Health (Licence: FL mh8347) | |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2013-03-12 |