NPI | 1205806981 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 8629) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: NY 8629) |
103T00000X Psychologist (Licence: NY 8629) | |
103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NY 8629) | |
103TA0700X Psychologist, Adult Development & Aging (Licence: NY 8629) | |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 8629) | |
103TC0700X Psychologist, Clinical (Licence: NY 008629) | |
103TC0700X Psychologist, Clinical (Licence: NC PP6551) | |
103TC0700X Psychologist, Clinical (Licence: FL TPPY2772) | |
103TC1900X Psychologist, Counseling (Licence: NY 8629) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 8629) | |
103TF0000X Psychologist, Family (Licence: NY 8629) | |
103TH0100X Psychologist, Health Service (Licence: NY 8629) | |
Enumeration Date | 2006-01-25 |
Last Update Date | 2024-08-21 |