| NPI | 1447828785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 093640) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 16720) |
| 104100000X Social Worker (Licence: NY 075064) | |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2024-05-14 |