NPI | 1205811346 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: NC 698) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 698) |
101YP2500X Counselor, Professional (Licence: NC 698) | |
1041C0700X Social Worker, Clinical (Licence: NC 698) | |
106H00000X Marriage & Family Therapist (Licence: NC 698) | |
Enumeration Date | 2005-12-13 |
Last Update Date | 2023-05-04 |