| NPI | 1396938163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| 101YP2500X Counselor, Professional | |
| 103K00000X Behavior Analyst | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2015-12-10 |