| NPI | 1881660967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TN P2225) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| 103TF0000X Psychologist Family | |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TP2701X Psychologist Group Psychotherapy | |
| 103T00000X Psychologist | |
| 103TH0100X Psychologist Health Service | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2007-09-01 |