NPI | 1700267721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health (Licence: CA PSB94024755) | |
103T00000X Psychologist | |
Enumeration Date | 2015-06-16 |
Last Update Date | 2024-04-19 |