NPI | 1619344298 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC008228) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC008228) |
106H00000X Marriage & Family Therapist (Licence: PA PC008228) | |
Enumeration Date | 2015-08-30 |
Last Update Date | 2015-08-30 |