NPI | 1477614899 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC000299) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: PA MF000121) |
Enumeration Date | 2006-12-12 |
Last Update Date | 2025-05-09 |