| NPI | 1336201151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041S0200X Social Worker, School |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY R0241711) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2025-09-11 |