| 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 |