NPI | 1376653774 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: OH 7370) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: OH P.7370) |
103T00000X Psychologist (Licence: MA 7134) | |
Enumeration Date | 2006-08-30 |
Last Update Date | 2021-01-13 |