NPI | 1790092179 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY0004093) |
Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: FL PY0004093) |
103TP2701X Psychologist, Group Psychotherapy (Licence: FL PY0004093) | |
106H00000X Marriage & Family Therapist (Licence: FL PY0004093) | |
Enumeration Date | 2010-09-08 |
Last Update Date | 2024-08-26 |