NPI | 1770180325 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TS0200X Psychologist, School (Licence: NY 023638) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 023638) |
Enumeration Date | 2020-10-07 |
Last Update Date | 2020-10-07 |