| NPI | 1770560849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy (Licence: IL 071-004374) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071-004374) |
| 103G00000X Clinical Neuropsychologist (Licence: IL 071-004374) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: IL 071-004374) | |
| 103TH0100X Psychologist, Health Service (Licence: IL 071-004374) | |
| 106H00000X Marriage & Family Therapist (Licence: IL 071-004374) | |
| 103T00000X Psychologist (Licence: IL 071-004374) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: IL 071-004374) | |
| 103TC1900X Psychologist, Counseling (Licence: IL 071-004374) | |
| 103TF0000X Psychologist, Family (Licence: IL 071-004374) | |
| 103TF0200X Psychologist, Forensic (Licence: IL 071-004374) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2025-09-11 |