NPI | 1801117437 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TS0200X Psychologist, School (Licence: LA 756) |
Additional Taxonomies | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances (Licence: LA 756) |
Enumeration Date | 2010-06-17 |
Last Update Date | 2010-06-24 |