NPI | 1144328931 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ PC01046) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NJ FI0014959) |
Enumeration Date | 2006-09-20 |
Last Update Date | 2024-11-22 |