| NPI | 1083630867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 000080) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: NY 049517) |
| 1835P1300X Pharmacist, Psychiatric (Licence: CA 53470) | |
| 1835P1300X Pharmacist, Psychiatric (Licence: FL PS45136) | |
| 106H00000X Marriage & Family Therapist (Licence: CA 41291) | |
| 1835P1300X Pharmacist, Psychiatric (Licence: NV 16290) | |
| 1835P1300X Pharmacist, Psychiatric (Licence: NC 20780) | |
| 1835P1300X Pharmacist, Psychiatric (Licence: MA 21831) | |
| 1835P1300X Pharmacist, Psychiatric (Licence: CT PCT0010037) | |
| 101YP2500X Counselor, Professional (Licence: CA LPC118) | |
| 101YM0800X Counselor, Mental Health (Licence: FL MH11320) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2013-12-19 |