NPI | 1073757746 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 005276) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: NY 2183213) |
Enumeration Date | 2009-04-26 |
Last Update Date | 2018-06-13 |