NPI | 1063430155 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35000883A) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39000584A) |
1041C0700X Social Worker, Clinical (Licence: IN 34002563A) | |
Enumeration Date | 2006-07-17 |
Last Update Date | 2025-09-11 |