NPI | 1396905857 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-251) |
Additional Taxonomies | 101Y00000X Counselor (Licence: ID LCPC-251) |
106H00000X Marriage & Family Therapist (Licence: ID LCPC-251) | |
Enumeration Date | 2008-06-09 |
Last Update Date | 2008-06-09 |