| NPI | 1346369097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00056700) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC0145) |
| 101YM0800X Counselor, Mental Health (Licence: NY 005740-1) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2019-11-25 |