NPI | 1831169861 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301013084) |
Additional Taxonomies | 101YS0200X Counselor, School (Licence: MI 6401000662) |
103G00000X Clinical Neuropsychologist (Licence: MI 6301013084) | |
103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MI 6301013084) | |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: MI 6301013084) | |
103TC0700X Psychologist, Clinical (Licence: MI 6301013084) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301013084) | |
103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MI 6301013084) | |
103TP2701X Psychologist, Group Psychotherapy (Licence: MI 6301013084) | |
103TS0200X Psychologist, School (Licence: IN 725698) | |
103TS0200X Psychologist, School (Licence: MI 102165) | |
1041C0700X Social Worker, Clinical (Licence: MI 6801058142) | |
106H00000X Marriage & Family Therapist (Licence: MI 4101005461) | |
Enumeration Date | 2006-01-24 |
Last Update Date | 2021-07-19 |