| NPI | 1063977189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH P.07856) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: OH P.07856) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH P.07856) | |
| 103TF0000X Psychologist, Family (Licence: OH P.07856) | |
| 103TF0200X Psychologist, Forensic (Licence: OH P.07856) | |
| 103TP0814X Psychologist, Psychoanalysis (Licence: OH P.07856) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: OH P.07856) | |
| 103T00000X Psychologist (Licence: OH P.07856) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: OH P.07856) | |
| Enumeration Date | 2019-02-02 |
| Last Update Date | 2022-08-14 |