| NPI | 1881733087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NY 000221-1) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 003149) |
| 101YM0800X Counselor, Mental Health (Licence: NY 003149-1) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2011-05-31 |