| 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 |