NPI | 1396843454 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NJ 37pc00105200) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37pc00105200) |
106H00000X Marriage & Family Therapist (Licence: NJ 37pc00105200) | |
Enumeration Date | 2006-09-20 |
Last Update Date | 2007-07-08 |