| NPI | 1285664706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: PA SW004486E) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA SW004486E) |
| 101YP1600X Counselor, Pastoral (Licence: PA SW004486E) | |
| 101YP2500X Counselor, Professional (Licence: PA SW004486E) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2025-09-11 |