NPI | 1285878231 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: NJ 44SL05150000) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: None) |
174400000X Specialist (Licence: NJ S-2219) | |
Enumeration Date | 2009-04-21 |
Last Update Date | 2009-04-21 |