| NPI | 1093552838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: PA SW141756) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2024-07-16 |