NPI | 1780817916 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: NY 023722-01) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2009-09-04 |
Last Update Date | 2020-07-22 |