NPI | 1013178771 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA CW015984) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW015984) |
Enumeration Date | 2008-06-24 |
Last Update Date | 2015-04-30 |