| NPI | 1326801929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY NYCPS-5947) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NY NYCPS-5947) |
| 106H00000X Marriage & Family Therapist (Licence: NY NYCPS-5947) | |
| 101YP2500X Counselor, Professional (Licence: NY NYCPS-5947) | |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-02-05 |