| NPI | 1275810087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 005404-1) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NY 005404-1) |
| 101YM0800X Counselor, Mental Health (Licence: PA PC012896) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 192617) | |
| 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00516400) | |
| 101YM0800X Counselor, Mental Health (Licence: AZ LPC-19636) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 27480) | |
| 101YM0800X Counselor, Mental Health (Licence: FL MH18912) | |
| 101YM0800X Counselor, Mental Health (Licence: CT 005022) | |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2023-11-13 |