| NPI | 1346362951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NY 006741-1) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: NY 006741-1) |
| 101YM0800X Counselor, Mental Health | |
| 102L00000X Psychoanalyst (Licence: NY 006741-1) | |
| 103T00000X Psychologist (Licence: NY 006741-1) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NY 006741-1) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 006741-1) | |
| 103TC0700X Psychologist, Clinical (Licence: NY 006741-1) | |
| 103TC1900X Psychologist, Counseling (Licence: NY 006741-1) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 006741-1) | |
| 103TF0000X Psychologist, Family (Licence: NY 006741-1) | |
| 103TF0200X Psychologist, Forensic (Licence: NY 006741-1) | |
| 103TP0814X Psychologist, Psychoanalysis (Licence: NY 006741-1) | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NY 006741-1) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2019-08-28 |