| NPI | 1356881726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 095367) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: NY 095367) |
| 1041C0700X Social Worker, Clinical | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 095367) | |
| 101YM0800X Counselor, Mental Health (Licence: NY 095367) | |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2025-06-05 |