NPI | 1679326318 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: NY 11983701) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 11983701) |
101Y00000X Counselor (Licence: NY 11983701) | |
Enumeration Date | 2024-04-11 |
Last Update Date | 2024-04-11 |