| NPI | 1801203625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC01153200) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NJ 37AC00540900) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2025-06-23 |