NPI | 1689990350 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TS0200X Psychologist, School (Licence: NY 522615041) |
Additional Taxonomies | 101YS0200X Counselor, School (Licence: WA 405422g) |
103TC1900X Psychologist, Counseling (Licence: PR 1755) | |
103TS0200X Psychologist, School (Licence: WA 405422G) | |
Enumeration Date | 2010-04-20 |
Last Update Date | 2010-04-20 |