| NPI | 1841003019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NJ 37PC01105700) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NJ 37PC01105700) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NJ 37LC00399400) | |
| 101YM0800X Counselor Mental Health (Licence: NJ 37PC01105700) | |
| Enumeration Date | 2025-01-30 |
| Last Update Date | 2025-01-30 |