NPI | 1164575064 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: NY 011086) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NH 999) |
103TH0100X Psychologist, Health Service (Licence: NY 011086) | |
103TH0100X Psychologist, Health Service (Licence: NH 999) | |
103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NH 999) | |
103G00000X Clinical Neuropsychologist (Licence: NY 011086) | |
103G00000X Clinical Neuropsychologist (Licence: NH 999) | |
103T00000X Psychologist (Licence: NH 999) | |
103TA0700X Psychologist, Adult Development & Aging (Licence: NY 011086) | |
103TA0700X Psychologist, Adult Development & Aging (Licence: NH 999) | |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 011086) | |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: NH 999) | |
103TC0700X Psychologist, Clinical (Licence: NY 011086) | |
103TC0700X Psychologist, Clinical (Licence: NH 999) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 011086) | |
Enumeration Date | 2007-01-22 |
Last Update Date | 2022-06-24 |