| NPI | 1730497389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: PA PS106949) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS106949) |
| 103K00000X Behavior Analyst (Licence: PA PS106949) | |
| 106H00000X Marriage & Family Therapist (Licence: PA PS106949) | |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2016-03-07 |