| NPI | 1215750054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL06246700) |
| Enumeration Date | 2024-10-31 |
| Last Update Date | 2024-10-31 |