NPI | 1124224290 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YS0200X Counselor, School (Licence: MA 273341) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: MA 753) |
Enumeration Date | 2007-06-25 |
Last Update Date | 2007-07-08 |