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 |