| NPI | 1396461224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09928735) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO 0009924049) |
| 101Y00000X Counselor (Licence: CO CSW.09928735) | |
| 101YM0800X Counselor, Mental Health (Licence: CO 0009924049) | |
| 101YM0800X Counselor, Mental Health (Licence: CO CSW.09928735) | |
| 102L00000X Psychoanalyst (Licence: CO 0009924049) | |
| 102L00000X Psychoanalyst (Licence: CO CSW.09928735) | |
| 104100000X Social Worker (Licence: CO 0009924049) | |
| 104100000X Social Worker (Licence: CO CSW.09928735) | |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2022-10-27 |