NPI | 1275859886 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149013021) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180006627) |
Enumeration Date | 2010-04-08 |
Last Update Date | 2010-04-08 |