| NPI | 1346413093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW024673) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical (Licence: PA SW123785) | |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2024-05-08 |