NPI | 1801203625 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NJ 37AC00540900) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2014-07-14 |
Last Update Date | 2020-10-27 |