| NPI | 1184208894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA LMHC10001034) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37PC00678300) |
| 163W00000X Registered Nurse (Licence: NJ 26NR24654600) | |
| 101YP2500X Counselor, Professional (Licence: DE PC-0011237) | |
| 101YP2500X Counselor, Professional (Licence: PA PC016597) | |
| Enumeration Date | 2021-05-09 |
| Last Update Date | 2024-01-04 |