NPI | 1255665030 |
---|---|
Former Name | BRIAN ERIC KENNEDY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 011500) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2009-09-25 |
Last Update Date | 2023-10-04 |