| NPI | 1144621376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 8649-123) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 102L00000X Psychoanalyst | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 1041C0700X Social Worker, Clinical (Licence: WI 8649) | |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2024-05-13 |