NPI | 1437518073 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 25269) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2016-02-10 |
Last Update Date | 2024-01-14 |