NPI | 1700990884 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH 1041C0700X 5.0031124) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: OH 1041C0700X 5.0031124) |
103TC1900X Psychologist, Counseling (Licence: OH 1041C0700X 5.0031124) | |
103T00000X Psychologist (Licence: OH 1041C0700X 5.0031124) | |
103TP2701X Psychologist, Group Psychotherapy (Licence: OH 1041C0700X 5.0031124) | |
1041C0700X Social Worker, Clinical (Licence: OH 1041C0700X 5.0031124) | |
Enumeration Date | 2006-08-18 |
Last Update Date | 2007-07-08 |