| NPI | 1811907843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 7314-123) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 7314-123) |
| 106H00000X Marriage & Family Therapist (Licence: WI 7314-123) | |
| 101YM0800X Counselor, Mental Health (Licence: WI 7314-123) | |
| 101Y00000X Counselor (Licence: WI 7314-123) | |
| 104100000X Social Worker (Licence: WI 7314-123) | |
| 171M00000X Case Manager/Care Coordinator (Licence: WI 7314-123) | |
| 1041C0700X Social Worker, Clinical (Licence: NY 071602) | |
| 101YP2500X Counselor, Professional (Licence: NY 071602) | |
| 101YM0800X Counselor, Mental Health (Licence: NY 071602) | |
| 102L00000X Psychoanalyst (Licence: NY 071602) | |
| 104100000X Social Worker (Licence: NY 071602) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-08-16 |