NPI | 1720252992 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AL 2323C) |
Additional Taxonomies | 101Y00000X Counselor |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
101YM0800X Counselor, Mental Health | |
102L00000X Psychoanalyst | |
104100000X Social Worker | |
1041S0200X Social Worker, School | |
Enumeration Date | 2008-04-17 |
Last Update Date | 2012-02-01 |