NPI | 1346269842 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: PA MF000083) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW012901) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2017-03-01 |