| NPI | 1487132734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NJ 37PC01041400) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2024-10-23 |