| NPI | 1447048699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YS0200X Counselor, School |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 103TS0200X Psychologist, School | |
| 1041S0200X Social Worker, School | |
| Enumeration Date | 2025-04-28 |
| Last Update Date | 2025-04-28 |