NPI | 1023220290 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY P022115-1) |
Additional Taxonomies | 1041S0200X Social Worker, School |
101YM0800X Counselor, Mental Health (Licence: NY 002388-1) | |
Enumeration Date | 2007-05-03 |
Last Update Date | 2025-09-11 |