| NPI | 1811076151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34002888) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34002888A) |
| 106H00000X Marriage & Family Therapist (Licence: IN 35000070) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2024-06-05 |