NPI | 1225131253 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R046010-1) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NY R046010-1) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 10882/R046010-1) | |
101YM0800X Counselor, Mental Health (Licence: NY R046010-1) | |
101YP2500X Counselor, Professional (Licence: NY R046010-1) | |
106H00000X Marriage & Family Therapist (Licence: NY R046010-1) | |
Enumeration Date | 2006-09-06 |
Last Update Date | 2021-08-18 |