NPI | 1336731413 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 012254) |
Additional Taxonomies | 101Y00000X Counselor |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
101YP1600X Counselor, Pastoral | |
101YP2500X Counselor, Professional | |
1041C0700X Social Worker, Clinical (Licence: NY 120111) | |
Enumeration Date | 2021-02-09 |
Last Update Date | 2025-08-21 |