NPI | 1245369727 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TF0000X Psychologist, Family |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YP1600X Counselor, Pastoral | |
103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
103TB0200X Psychologist, Cognitive & Behavioral | |
103TC0700X Psychologist, Clinical (Licence: CO 1015) | |
103TC1900X Psychologist, Counseling | |
103TC2200X Psychologist, Clinical Child & Adolescent | |
106H00000X Marriage & Family Therapist | |
Enumeration Date | 2007-03-02 |
Last Update Date | 2008-11-20 |